Embodiments herein relate to tracking trends in left ventricular conduction patterns and morphology in connection with monitoring heart failure progression.
Implantable medical devices (IMD) provide various types of electrical stimulation, such as in connection with delivering pacing therapy to one or more select chambers of the heart. An IMD may provide both unipolar and bipolar pacing and/or sensing configurations. In the unipolar configuration, the pacing pulses are applied (or responses are sensed) between an electrode carried by the lead and a case of the pulse generator or a coil electrode of another lead within the heart. In the bipolar configuration, the pacing pulses are applied (or responses are sensed) between a pair of electrodes carried by the same lead. IMD's may implement single-chamber or dual-chamber functionality. Recently, IMDs have been introduced that stimulate multiple sites in the same chamber, termed multisite stimulation systems or multi-purpose pacing systems.
Recently, multi-point pacing (MPP) technology has enabled pacing at multiple left ventricular (LV) sites to improve synchrony in cardiac resynchronization therapy (CRT) patients.
However, over time, at least some CRT patients experience a progression of heart failure disease. Today, heart failure disease progression in CRT patients is generally only monitored in a limited manner, such as during in clinic follow-up visits. During an in clinic visit, echocardiography signals are collected to measure a patient's hemodynamics and/or electrocardiography (ECG) signals are collected to measure the patient's electrical synchrony. In clinic visits provide a single time point snapshot of a patient's cardiovascular status. In clinic visits are infrequent and in some instances, may be performed only after a heart failure disease has progressed to a significant level requiring a patient to be hospitalized. Current systems for monitoring heart failure (HF) disease progression do not afford daily trends in the disease progression.